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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />�(A - C `c C— P hGVL \ <br />�Ilw r Mail Address City 4 `�k_S ip w' Phone <br />Tenant Mail Address City State/Zip Phone <br />_AN(S� I�01z ls-f-/Iyc r 1r wA- <br />Electrical Contractor Mail Address City Q �.Z,Z State/Zip ;5b, Phone <br />l 3 kA��, - <br />(S f � OC3� 2-�— - Ici <br />State License Number Contract Price of Work <br />C D +L3U 7- <br />Ptbposed Use of Building j <br />1 Contact Person (Plan Review) <br />Description offp Work to Be Done:r �0b\(_ vz� 2 — nv1-� j:? Co V-,A-y c, ,� <br />c <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the Previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />Signature Date <br />�£G7-052— <br />